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Partial resection of the infrapatellar fat pad during anterior cruciate ligament reconstruction has no effect on clinical outcomes including anterior knee pain

Archives of Orthopaedic and Trauma Surgery volume 140, pages 1751–1757 (2020)Cite this article

Abstract

Background

Anterior knee pain (AKP) is a major complication that occurs after anterior cruciate ligament reconstruction (ACLR), even when hamstring tendon (HT) grafts are used. Damage to the infrapatellar fat pad (IPFP) during arthroscopy can cause AKP. The purpose of this study was to evaluate the influence of IPFP preservation on clinical outcomes, including AKP, in patients who underwent ACLR with HT autografts using the inside-out technique.

Methods

Forty-two patients who underwent primary ACLR with HT autografts were prospectively assessed for 2 years after surgery. They were randomly selected to undergo treatment with as much intercondylar IPFP preservation as possible or with intercondylar IPFP resection to confirm the ACL origin on the femoral and tibial sides, especially the femoral footprint in deep flexion of the knee joint. The total IPFP volume was calculated using sagittal MR images before and 6 months after surgery. The patients completed a subjective knee score questionnaire and were assessed for patellar tendon tenderness and pain with the half-squat test or single-leg hop test at 6 months and 2 years postoperatively.

Results

There were no differences in the patient characteristics, including age, sex, BMI, time from injury to surgery, and meniscus tear. The difference in the total size of the IPFP preserved was significant (P = 0.004). However, there were no significant differences in the subjective knee scores. Moreover, there were no differences in the clinical assessment parameters between the IPFP preservation and resection groups.

Conclusions

The size of the IPFP decreased more in the resection group than in the preservation group at 6 months after surgery. However, partial IPFP resection, which was used to better visualize the origin of the ACL, had no effect on the clinical outcomes, including AKP.

Level of evidence

Level II.

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Fig. 1

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Affiliations

  1. Department of Orthopaedic Surgery, Graduate School of Medical Science, Kanazawa University, 13-1 Takara-machi, Kanazawa, 920-8641, Japan

    Kazuki Asai, Junsuke Nakase, Takeshi Oshima, Kengo Shimozaki, Rikuto Yoshimizu & Hiroyuki Tsuchiya

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  1. Kazuki Asai
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  2. Junsuke Nakase
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  3. Takeshi Oshima
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Correspondence to Junsuke Nakase.

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This study was approved by the Ethics Committee of our hospital (1842-1).

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Informed consent was obtained from all individual participants included in the study.

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Asai, K., Nakase, J., Oshima, T. et al. Partial resection of the infrapatellar fat pad during anterior cruciate ligament reconstruction has no effect on clinical outcomes including anterior knee pain. Arch Orthop Trauma Surg 140, 1751–1757 (2020). https://doi.org/10.1007/s00402-020-03520-5

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  • DOI: https://doi.org/10.1007/s00402-020-03520-5

Keywords

  • Anterior cruciate ligament reconstruction
  • Infrapatellar fat pad
  • Anterior knee pain
  • Hamstring tendon grafts